Paul DeChant MD, MBA
Reducing Burnout - An Overview
In a recent post on understanding burnout, we reviewed what burnout is (the manifestation in an individual of dysfunction in the workplace) and discussed the way it manifests as exhaustion, cynicism, and inefficacy.
Let's talk about how to reduce burnout
You may wonder if we should talk about the causes - the drivers of burnout - before we talk about how to reduce it? Otherwise, aren't we likely to waste time and resources, and potentially make things worse, if we are not addressing the root causes of burnout?
You're right. To reduce burnout we need to fix the underlying root cause.
However, for today I'd like to provide an overview of the three broad categories of burnout interventions. Once we have that context, we can get talk specific activities to pursue within each of the categories.
The Stanford WellMD Model
Dr. Tait Shanafelt and the WellMD team at Stanford Medical School developed this graphic that shows three areas of focus that are important in order to reduce burnout and achieve professional fulfillment:
Efficiency of Practice
Culture of Wellness
Work on the top two components of the model focuses on fixing the workplace. The bottom component focuses on helping clinicians cope with the experience of burnout.
The vast majority of work on reducing burnout has focused on helping clinicians cope, to improve Personal Resilience. As we know, clinicians are already some of the most resilient people in the world, so while we can always learn to further enhance our resilience, and this work is needed to help burned out clinicians cope with overwhelming stress, we need to do more.
That's where the other two components come in. Drs. Christina Maslach and Michael Leiter have identified six drivers of burnout.
The first driver is work overload, which drives the manifestation of exhaustion. We can reduce work overload by redesigning how the work is done. This is the focus on the Efficiency of Practice component of the Stanford WellMD model. A number of organizations are focusing on this approach, with varying levels of success.
The other five drivers of burnout drive cynicism. These are:
Lack of control
Breakdown of community
Absence of fairness
These all have to do with leadership and management
And work on these is key to the Culture of Wellness component of the model. This is the component where I see the least engagement in healthcare systems across the country, actually across the world.
With this context as a framework and this model in mind, over the next few weeks we will dive deeper into each of the components of the model, starting with Personal Resilience.
Resilience work is absolutely vital to help clinicians cope with the considerable dysfunction in clinical workplaces, and is absolutely insufficient if we hope to reduce burnout and enable clinicians to experience joy and professional fulfillment in the work that they have committed their lives to.
If you have thoughts or questions you would like to share, please do so in the comments below, or email me directly at firstname.lastname@example.org
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